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18-08-2018 | Uitgave 12/2018

Quality of Life Research 12/2018

Child maltreatment as a social determinant of midlife health-related quality of life in women: do psychosocial factors explain this association?

Quality of Life Research > Uitgave 12/2018
Hsing-Hua S. Lin, Ashley I. Naimi, Maria M. Brooks, Gale A. Richardson, Jessica G. Burke, Joyce T. Bromberger
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The online version of this article (https://​doi.​org/​10.​1007/​s11136-018-1937-x) contains supplementary material, which is available to authorized users.



We examined if child maltreatment (CM) is associated with worse health-related quality of life (HRQoL) in midlife women and if the association is mediated by psychosocial factors.


A total of 443 women were enrolled in the Pittsburgh site of the longitudinal Study of Women’s Health Across the Nation-Mental Health Study. The analytic sample included 338 women who completed the SF-36 and the Childhood Trauma Questionnaire. Generalized linear regression was used to assess the association between CM and two HRQoL component scores. Structural nested mean models were used to evaluate the contribution of each psychosocial mediator (lifetime psychiatric history, depressive symptoms, sleep problems, very upsetting life events, low social support) to the association.


Thirty-eight percent of women reported CM. The mean mental (MCS) and physical (PCS) SF-36 component scores were 2.3 points (95% CI − 4.3, − 0.3) and 2.5 points (95% CI − 4.5, − 0.6) lower, respectively, in women with any CM than in those without. When number of CM types increased (0, 1, 2, 3+ types), group mean scores decreased in MCS (52, 51, 48, 47, respectively; p < .01) and PCS (52, 52, 49, 49, respectively; p = .03). In separate mediation analyses, depressive symptoms, very upsetting life events, or low social support, reduced these differences in MCS, but not PCS.


CM is a social determinant of midlife HRQoL in women. The relationship between CM and MCS was partially explained by psychosocial mediators. It is important to increase awareness among health professionals that a woman’s midlife well-being may be influenced by early-life adversity.

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